Data Documentation

Original Medicare (Fee-for-Service) Durable Medical Equipment
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For most files, a table of variables will display below, with links to the variable definitions. If no table displays, or if you need additional information for a specific variable, please see the CCW website. Data documentation is available for all files and codebooks for many.

If you are unable to locate the information you need, please contact ResDAC.

CCW Codebook - Medicare Fee-For-Service (FFS) Claims

CCW Record Layout - Medicare Fee-For-Service (FFS) Claims

Base Claim File
Line File
Demonstrations/Innovations Code File

Base Claim File
SAS Name Variable Name
BENE_ID Encrypted CCW Beneficiary ID
CLM_ID Claim ID
NCH_NEAR_LINE_REC_IDENT_CD NCH Near Line Record Identification Code (RIC)
NCH_CLM_TYPE_CD NCH Claim Type Code
CLM_FROM_DT Claim From Date (FFS)
CLM_THRU_DT Claim Through Date (FFS)
NCH_WKLY_PROC_DT NCH Weekly Claim Processing Date
CARR_CLM_ENTRY_CD Carrier Claim Entry Code
CLM_DISP_CD Claim Disposition Code
CARR_NUM Carrier or MAC Number
CARR_CLM_PMT_DNL_CD Carrier Claim Payment Denial Code
CLM_PMT_AMT Claim (Medicare) Payment Amount
NCH_PRMRY_PYR_CLM_PD_AMT NCH Primary Payer (if not Medicare) Claim Paid Amount
CARR_CLM_PRVDR_ASGNMT_IND_SW Carrier Claim Provider Assignment Indicator Switch
NCH_CLM_PRVDR_PMT_AMT NCH Claim Provider Payment Amount
NCH_CLM_BENE_PMT_AMT NCH Claim Payment Amount to Beneficiary
CLM_BENE_PD_AMT Carrier Claim Beneficiary Paid Amount
NCH_CARR_CLM_SBMTD_CHRG_AMT NCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)
NCH_CARR_CLM_ALOWD_AMT NCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)
CARR_CLM_CASH_DDCTBL_APLD_AMT Carrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)
CARR_CLM_HCPCS_YR_CD Claim Healthcare Common Procedure Coding System (HCPCS) Year Code
PRNCPAL_DGNS_CD Claim Principal Diagnosis Code (FFS)
PRNCPAL_DGNS_VRSN_CD Claim Principal Diagnosis Version Code (FFS)
ICD_DGNS_CD1 Claim Diagnosis Code I (FFS)
ICD_DGNS_VRSN_CD1 Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD2 Claim Diagnosis Code II (FFS)
ICD_DGNS_VRSN_CD2 Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD3 Claim Diagnosis Code III (FFS)
ICD_DGNS_VRSN_CD3 Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD4 Claim Diagnosis Code IV (FFS)
ICD_DGNS_VRSN_CD4 Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD5 Claim Diagnosis Code V (FFS)
ICD_DGNS_VRSN_CD5 Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD6 Claim Diagnosis Code VI (FFS)
ICD_DGNS_VRSN_CD6 Claim Diagnosis Code VI Diagnosis Version Code (ICD-9/ICD-10) (FFS)
ICD_DGNS_CD7 Claim Diagnosis Code VII (FFS)
ICD_DGNS_VRSN_CD7 Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD8 Claim Diagnosis Code VIII (FFS)
ICD_DGNS_VRSN_CD8 Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD9 Claim Diagnosis Code IX (FFS)
ICD_DGNS_VRSN_CD9 Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD10 Claim Diagnosis Code X (FFS)
ICD_DGNS_VRSN_CD10 Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD11 Claim Diagnosis Code XI (FFS)
ICD_DGNS_VRSN_CD11 Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD12 Claim Diagnosis Code XII (FFS)
ICD_DGNS_VRSN_CD12 Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
RFR_PHYSN_UPIN Carrier/DMERC Claim Ordering Physician UPIN Number
RFR_PHYSN_NPI Claim Referring Physician NPI Number
CLM_CLNCL_TRIL_NUM Clinical Trial Number
DOB_DT Date of Birth from Claim
BENE_RACE_CD Beneficiary Race Code (FFS)
BENE_CNTY_CD County Code from Claim (SSA)
BENE_STATE_CD Beneficiary Residence (SSA) State Code (FFS)
BENE_MLG_CNTCT_ZIP_CD Zip Code of Residence from Claim
ACO_ID_NUM Claim Accountable Care Organization (ACO) Identification Number
CLM_BENE_ID_TYPE_CD Claim Beneficiary Identifier Type Code
CLM_RSDL_PYMT_IND_CD Claim Residual Payment Indicator Code

Line File
SAS Name Variable Name
BENE_ID Encrypted CCW Beneficiary ID
CLM_ID Claim ID
CLM_LINE_NUM Claim Line Number
NCH_CLM_TYPE_CD NCH Claim Type Code
CLM_THRU_DT Claim Through Date (FFS)
TAX_NUM Line Provider Tax Number
PRVDR_SPCLTY Line CMS Provider Specialty Code
PRTCPTNG_IND_CD Line Provider Participating Indicator Code
LINE_SRVC_CNT Line Service Count (FFS)
LINE_CMS_TYPE_SRVC_CD Line CMS Type Service Code
LINE_PLACE_OF_SRVC_CD Line Place Of Service Code (FFS)
LINE_1ST_EXPNS_DT Line First Expense Date (FFS)
LINE_LAST_EXPNS_DT Line Last Expense Date (FFS)
HCPCS_CD Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
HCPCS_1ST_MDFR_CD HCPCS Initial Modifier Code (FFS)
HCPCS_2ND_MDFR_CD HCPCS Second Modifier Code (FFS)
HCPCS_3RD_MDFR_CD HCPCS Third Modifier Code (FFS)
HCPCS_4TH_MDFR_CD HCPCS Fourth Modifier Code (FFS)
BETOS_CD Line Berenson-Eggers Type of Service (BETOS) Code
LINE_NCH_PMT_AMT Line NCH Medicare Payment Amount
LINE_BENE_PMT_AMT Line Payment Amount to Beneficiary
LINE_PRVDR_PMT_AMT Line Provider Payment Amount
LINE_BENE_PTB_DDCTBL_AMT Line Beneficiary Part B Deductible Amount
LINE_BENE_PRMRY_PYR_CD Line Primary Payer Code (if not Medicare)
LINE_BENE_PRMRY_PYR_PD_AMT Line Primary Payer (if not Medicare) Paid Amount
LINE_COINSRNC_AMT Line Beneficiary Coinsurance Amount
LINE_PRMRY_ALOWD_CHRG_AMT Line Primary Payer Allowed Charge Amount
LINE_SBMTD_CHRG_AMT Line Submitted Charge Amount
LINE_ALOWD_CHRG_AMT Line Allowed Charge Amount
LINE_PRCSG_IND_CD Line Processing Indicator Code
LINE_PMT_80_100_CD Line Payment 80%/100% Code
LINE_SERVICE_DEDUCTIBLE Line Service Deductible Indicator Switch
LINE_ICD_DGNS_CD Line Diagnosis Code
LINE_ICD_DGNS_VRSN_CD Line Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10)
LINE_DME_PRCHS_PRICE_AMT Line DME Purchase Price Amount
PRVDR_NUM DMERC Line Supplier Provider Number
PRVDR_NPI DMERC Line-Item Supplier NPI Number
DMERC_LINE_PRCNG_STATE_CD DMERC Line Pricing State Code (SSA)
PRVDR_STATE_CD NCH Provider SSA State Code
DMERC_LINE_SUPPLR_TYPE_CD DMERC Line Supplier Type Code
DMERC_LINE_SCRN_SVGS_AMT DMERC Line Screen Savings Amount
DMERC_LINE_MTUS_CNT DMERC Line Miles/Time/Units/Services (MTUS) Count
DMERC_LINE_MTUS_CD DMERC Line Miles/Time/Units/Services (MTUS) Indicator Code
LINE_HCT_HGB_RSLT_NUM Hematocrit/Hemoglobin Test Results
LINE_HCT_HGB_TYPE_CD Hematocrit/Hemoglobin Test Type Code
LINE_NDC_CD Line National Drug Code (NDC) (FFS)
LINE_OTHR_APLD_IND_CD1 Line Other Applied Indicator 1st Code
LINE_OTHR_APLD_IND_CD2 Line Other Applied Indicator 2nd Code
LINE_OTHR_APLD_IND_CD3 Line Other Applied Indicator 3rd Code
LINE_OTHR_APLD_IND_CD4 Line Other Applied Indicator 4th Code
LINE_OTHR_APLD_IND_CD5 Line Other Applied Indicator 5th Code
LINE_OTHR_APLD_IND_CD6 Line Other Applied Indicator 6th Code
LINE_OTHR_APLD_IND_CD7 Line Other Applied Indicator 7th Code
LINE_OTHR_APLD_AMT1 Line Other Applied Amount for 1st Code
LINE_OTHR_APLD_AMT2 Line Other Applied Amount for 2nd Code
LINE_OTHR_APLD_AMT3 Line Other Applied Amount for 3rd Code
LINE_OTHR_APLD_AMT4 Line Other Applied Amount for 4th Code
LINE_OTHR_APLD_AMT5 Line Other Applied Amount for 5th Code
LINE_OTHR_APLD_AMT6 Line Other Applied Amount for 6th Code
LINE_OTHR_APLD_AMT7 Line Other Applied Amount for 7th Code
LINE_RSDL_PYMT_IND_CD Line Residual Payment Indicator Code
LINE_RP_IND_CD Line Representative Payee (RP) Indicator Code
DMERC_LINE_FRGN_ADR_IND Line Foreign Address Indicator
LINE_RR_BRD_EXCLSN_IND_SW Line Railroad Board Exclusion Indicator Switch
LINE_VLNTRY_SRVC_IND_CD Line Voluntary Service Indicator Code
DMERC_OXGN_EQUIP_INITL_DT Oxygen Equipment Initial Date
DMERC_OXGN_INITL_DT_CD Oxygen Equipment Initial Date Code
DMERC_OXGN_EQUIP_PRVS_DT Oxygen Equipment Previous Date
CLM_NEXT_GNRTN_ACO_IND_CD1 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
CLM_NEXT_GNRTN_ACO_IND_CD2 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
CLM_NEXT_GNRTN_ACO_IND_CD3 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
CLM_NEXT_GNRTN_ACO_IND_CD4 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
CLM_NEXT_GNRTN_ACO_IND_CD5 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation

Demonstrations/Innovations Code File
SAS Name Variable Name
BENE_ID Encrypted CCW Beneficiary ID
CLM_ID Claim ID
NCH_CLM_TYPE_CD NCH Claim Type Code
DEMO_ID_SQNC_NUM Demonstration sequence number
DEMO_ID_NUM Demonstration number
DEMO_INFO_TXT Demo information text